THE GERIATRIC PATIENT

A SYSTEMIC APPROACH TO MAINTAIN

HEALTH

Ms Parimaladevi
INTRODUCTION
 The number of persons 65 years of older continue
to increase dramatically.

 Comprehensive health maintenance screening of

this population is becoming an important task for
nurses.

 Assessment categories unique to elderly patients

include health, psychological and social.
INTRODUCTION
 Interventional areas that the common to other age
groups but have special implications for older
patients.
 Using an organized approach to the varied aspects
of geriatric health, nurses can improve the care that
the provide for their older patients.
 Simple screening instruments can be helpful n
identifying patients at risk for common health
problems and in improving the clinical assessment
of a diseases course
INTRODUCTION
 Using simple and easily administered
assessment tools, nurses can improved
the identification of specific problems
that are common in the elderly and also
shift their focus from disease- specific
intervention to preventive care and
proactive medical management .
INTRODUCTION
 Standardize assessment tools and techniques
can be used in out patient setting
 The goals are to encourage a systemic

assessment of various areas of potential

geriatric risk and to developed a database
appropriate to the unique concerns of elderly
patients.
 Require multiple visits to perform the entire

assessment.
HEALTH ASSESSMENT OF OLDER ADULTS

 HEALTH ASSESSMENT OF OLDER

ADULTS
- Can be done on several ranging from
simple screening to complex.
- Require necessary skills and nowledge
to perform assessment correctly.
- Sensitive to the unique needs and
characteristics older adults
HEALTH SCREENING
 Perform to identify older individuals who
need to further and depth assessment.
 Available at health clinics to screen for

HPT, hearing problems, foot problems,

problems with ADL
 Design to identify older individuals with

significant findings and refer them to the

most appropriate health service provider.
SCREENING RECOMMENDATION FOR OLDER
ADULTS

 Blood pressure
 Clinical breast examination
 Mammogram
 Pap smear
 Cholesterol level
 Sigmoidoscopy
 Prostate examination
 Test for hearing impairment,visual acquity,thyroid
function
 Osteoporosis screen
INJURY PREVENTION
 Fall prevention , however ,is an assessment
category unique to patients 65 years of age
and older.
 E.g use a safety belts , the availability of

smoke detector, the maintenance of hot water

heater temperature and the danger of smoking
near bedding
 fall are responsible for a significant number of

accidental deaths and the traumatic injuries

among elderly
INJURY PREVENTION
 Geriatric patients are at higher risk of
falling for a number of reasons, including
 Postural hypertension

 Balance or gait impairment

 Poly pharmacy

 Use of sedative-hypnotic medication

RISK FACTORS
 Intrinsic factors that are contribute to falls include:
 -age-related changers in postural controls.

 Gait and visual ability

 The presence of acute and chronic diseases :

-CVA dizziness, blurring of vision.

-dizziness, blurring of vision
Musculoskeletal strength and coordination:
-osteoporosis
Medication : sedative
RISK FACTORS
 Extrinsic factors that contribute to falls
include:
- poor lighting
- obstructive furniture
- slippery floor
- loose floor coverings
- bathrooms without handrails or grab
bars
INTERVENTION TO REDUCE THE RISK OF
FALLING IN THE ELDERLY
 Decrease in the dosage of a medication that may
contribute to hypertension
 Educate, explain and guide to be given about the

appropriate use of sedative-hypnotic drugs.

 Nonpharmacologic treatment of sleep problems,

such as sleep restriction during day time

INTERVENTION TO REDUCE THE RISK OF
FALLING IN THE ELDERLY

 Home safety assessment with

appropriate changes, such as removal
of hazards, selection of safer
furniture:-
 (correct height, more stability) and

installation of structures such as grab

bars or handrails on stairs.
INTERVENTION TO REDUCE THE RISK OF
FALLING IN THE ELDERLY

 Gait training
 Use of an appropriate assistive device

 Balance or strengthening exercise.

 Balance exercises and training in transfer

skills
 Environmental alterations, such as

installation of grab bars or raise seats

SENSORY PERCEPTION

 Changers in vision and hearing

occurs as patients age.

 Regular vision and hearing

screening for patients 65 years of
age and older
VISION
 The most common causes of visual impairment in
the elderly include presbyopia, cataracts, glaucoma,
diabetic retinopathy and age related macular
degeneration.
 Changers in vision can cause significant number of
problems for elderly patients, including an
increased risk for falls.
 Tools of visual activity acuity screening in the
elderly “Snellen Chart”
HEARING
 The prevalence of hearing loss in the
geriatric population rangers from 14% >
 The most common cause of hearing

impairment in geriatric patients.

 Hearing loss in the elderly can adversely

affect physical, emotional and cognitive

well-being and lead to social isolation.
NUTRITION
 Malnutrition . Common yet frequent,
overlooked problems in the geriatric
population.
 Elderly patients with a compromised

nutritional state require longer hospital

stays and developed more complications
 One simple screening device for geriatric

nutrition is Nutritional Health Screen

NUTRITION
 May help to prevent nutritional
problems in at risk patients

 Recommendation for encouraging

regular tooth brushing, flossing and
dental visits gains importance in the
elderly
IMMUNIZATIONS
 Assessing the immunizations status of
geriatric patients and providing the
recommended vaccines. E.g- annual influeza
vaccination.
 - patients over 65 years of age should also
receive at least one pneumococcal vaccination
in the lifetime.
 - the tetanus diptheria(Td) toxoid should be
given every 10 years.
SEXUALITY

 Studies show that of married women show that

74% of married men and 56%